Fever: Myths and Facts

Fever: Myths and Facts!

It is the middle of the night. You go to check on your child and touch his forehead. He is hot to the touch though sleeping soundly without distress. What do you do?

Fever in a child is one of the most distressing symptoms parents will encounter and a common reason why parents call the pediatrician to seek medical advice. However, fever should not elicit such a fearful response. After sorting out parental fears vs facts about fever, I hope you will be able to provide appropriate care for your child without anxiety.

What is a fever? Fever is a body’s normal response to help fight off infections by producing helpful antibodies. Fever is considered a 100.4 degree or greater temperature rectally. Although this is the most accurate way of checking a temperature in babies and young toddlers, older kiddos temperature may be checked orally or by ear thermometer. Most importantly, parents need to know how to use the thermometer correctly. When you are reporting your child’s temperature, please report how you took the temperature and what the reading was. It is no longer recommended to add degrees as this can cause confusion.

If my child has a fever, do I need to bring down the temp immediately? Absolutely not! In February 28, 2011, the American Academy of Pediatrics published an online clinical report called “Fever and Antipyretic Use in Children” to help guide pediatricians on educating parents and caregivers about fever. The AAP states the primary goal of a parent whose child has a fever is to first make their child more comfortable, not to bring down the fever. Mild fevers (100.4-102 degrees) are actually therapeutic and can help children fight off their infection better than those whose fever is constantly suppressed. Therefore, if your child is sleeping comfortably but feels feverish, don’t wake them up to give fever reducing medicine! Your child will wake up when they feel uncomfortable. It is important to monitor/observe your child for signs of serious illness and alert the doctor if noted.

What can I do to help make my child more comfortable when they have a fever? Dress your child lightly. Give them a lukewarm bath or shower. Encouraged them to drink more liquids to stay hydrated (depending on the age, liquids can be in the form of breastmilk/formula, water, popsicles, ice chips, etc). If still uncomfortable, consider giving acetaminophen or ibuprofen – please follow the directions for each medication and make sure you have the correct measuring tool. You may visit our website at www.redbudpediatrics.com for appropriate dosages. NEVER give aspirin to a child!

Do higher temperatures mean the illness is more serious? Not necessarily! There are many common pediatric viral illnesses that can elicit higher temps but only require supportive care until the virus runs its course and resolve spontaneously.

How long should I allow my child to run a fever? The answer to this is dependent on a variety of factors. If your child is less than 3 month old, the doctor should be notified immediately (unless vaccines were just given – then follow your doctor’s advice for fever due to vaccines). For kids up to 36 months of age, fever alone for more than 48 hours warrants a visit to the doctor. For kids 3 years old and older, you can monitor your child’s fever for up to 4 days but definitely see a doctor if you have concerns other than fever. Any fever over 105 degrees for any age warrants a phone call.

When should I call my pediatrician? Please call immediately if your child:

• Is less than 3 months old and has a fever at or above 100.4 degrees rectally.
• Has a special medical condition (including but not limited to immune disorders, recent transplant or chemotherapy patients, sickle cell disorder, etc) and you have been told specifically to call if your child has a fever
• Has a seizure
• Is inconsolable, irritable, or you are unable to comfort/calm them
• Has a stiff neck
• Is lethargic – difficult to awaken, limp, confused (this is different from being “tired”)
• Is having trouble breathing
  • Can see outlines of their ribs or chest caves in
  • Prominently using their bellies to breathe
  • Wheezing/grunting sounds heard
  • Breathing a lot faster for their age
• Has joint pain/swelling/redness, refusal to properly use their arm or leg
• Has bloody diarrhea
• Drooling and unable to swallow
• Has signs of dehydration (may include dry mouth, less than 4 wet diapers per 24 hrs, sunken soft spot, unable to tolerate liquids, etc)
• Has a rash that looks like bruises OR small red spots that do not turn white when you press them (this is called blanching)
• Fever rises above 104 degrees repeatedly for a child of any age.
• Or other concerns that you feel warrant a call

Resources

1. 2/28/2011 AAP Issues Advice on Managing Fever in Children. https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Issues-Advice-on-Managing-Fevers-in-Children.aspx
2. The Big Book of Symptoms: A-Z Guide to Your Child’s Health – July 15, 2014. by American Academy of Pediatrics (Author), Steven P. Shelov (Editor), Shelly Vaziri Flais (Editor)
3. https://www.healthychildren.org/English/health-issues/conditions/fever/Pages/Fever-Without-Fear.aspx